Key Vote for Clinton Presidency White House Has Set Health-Care Reform as Its Defining Test, at a Time of Waning Influence

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THE debate has engaged as if in slow motion, as one by one senators take their turn in the well for opening remarks stretching across several days.

It marks the nearing of the end of a health-care battle that President Clinton has set up as the defining test of his presidency.

He is entering it politically weak and facing the prospect in coming months of getting politically weaker.

He has staked his reputation on a Roosevelt-scale feat now at hand - a feat at least one Democratic veteran considers unfinished business of the New Deal social-security agenda.

Yet he is operating in a very different climate from that of Roosevelt who passed Social Security 60 years ago.

Faith in government has collapsed over the past 15 years. Faith in Mr. Clinton is not faring much better.

Given the relatively prosperous economy, notes presidential scholar Colin Campbell of Georgetown University here, Clinton's public-approval ratings should be in the mid-60-percent range. Instead, they are in the mid-40-percent range, and no clear-cut explanation lies at hand for the missing 20 points - no Vietnam, no Watergate.

Personal distrust of Clinton runs especially high in polls. As if to keep that point fresh, the Senate speeches on health care are following two weeks of televised congressional hearings probing the integrity of the Clinton administration on Whitewater-related business.

Time is not on his side. In mid-term elections less than three months away, Democrats could lose 25 seats and effective control of the House of Representatives.

Discomfort runs high at the White House, where staffers are awaiting a shake-up at the hands of new chief of staff Leon Panetta. At the Democratic National Committee, dissatisfaction among Democratic politicos has put party chairman David Wilhelm on the way out, as former House leader Tony Coelho moves in to coordinate fall campaign activities.

Most Democrats would much rather face voters in November having achieved a major reform of the health-insurance system. It may be even more critical for Clinton himself, because he has tied his presidency so closely to achieving health-care reform on a grand scale. …